Quantifying Fear Avoidance Behaviors in People With Concussion: A COSMIN-Informed Systematic Review

The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess fear avoidance behavior in individuals with concussion and (2) assess the measurement properties of these PROMs. A systematic review...

Full description

Saved in:
Bibliographic Details
Published in:The journal of orthopaedic and sports physical therapy 2023-09, Vol.53 (9), p.540-565
Main Authors: Sherwood, Liam J, Korakakis, Vasileios, Mosler, Andrea B, Fortington, Lauren, Murphy, Myles C
Format: Article
Language:English
Subjects:
Avoidance Learning
Brain Concussion
Checklist
Humans
Patient Reported Outcome Measures
Psychometrics
Quality of Life
Reproducibility of Results
Sports
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The validity of existing fear avoidance behavior patient-reported outcome measures (PROMs) for concussion is unknown. This study aims to (1) identify PROMs that assess fear avoidance behavior in individuals with concussion and (2) assess the measurement properties of these PROMs. A systematic review of outcome measurement instruments using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. We performed a systematic search of 7 databases. Studies were included if they assessed fear avoidance behavior (eg, kinesiophobia or cogniphobia) in participants with concussion, occurring in all settings (eg, sport, falls, assaults). Methodological quality of the PROMs was assessed using the COSMIN checklist, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We identified 40 studies assessing fear avoidance. Four studies (n = 875 participants, representing 3 PROMs) were eligible for COSMIN assessment. Content validity for all PROMs was insufficient due to extreme risk of bias. The Fear Avoidance Short Form Scale demonstrated the greatest validity: moderate-certainty evidence for sufficient structural validity and internal consistency, and low-certainty evidence for measurement invariance. Current PROMs for measuring fear avoidance behaviors in people with concussion have insufficient content validity and should be used with caution in research and clinical practice. .
ISSN:0190-6011
1938-1344
DOI:10.2519/jospt.2023.11685